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NPI Code Detail

MEDICARE: ST CROIX COUNTY

MEDICARE: ST CROIX COUNTY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency1855WI
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932265105
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST CROIX COUNTY
Provider Business Mailing Address
First Line : 1752 DORSET LN
Second Line :
City : NEW RICHMOND
State : WI
Zip : 54017-2452
Country : US
Telephone Number : 715-246-6991
Fax Number :
Provider Business Practice Location Address
First Line : 1752 DORSET LN
Second Line :
City : NEW RICHMOND
State : WI
Zip : 54017-2452
Country : US
Telephone Number : 715-246-6991
Fax Number :
Authorized Official
Title or Position : DIRECTOR HEALTH AND HUMAN SERVICES
Name : ROBERT ROHRET
Credential :
Telephone Number : 715-246-8217
Provider Enumeration Date : 12/29/2006
Last Update Date : 11/06/2020

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Directions to “ST CROIX COUNTY ” Practice Location

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